Relationship Between Health Literacy And Cardiovascular Disease (CVD) Sample Assignment

To investigate the relationship among health literacy and Cardiovascular disease (CVD), Researchers, groups, and studies observed increased rates of childhood obesity as a top responsibility in today’s global world. Recognizing the current concern of overweight and obese juvenile children that may lead up to big health issues as in Cardiovascular Disease (CVD) (Schaik, et al., 2017). Different trials used study tools that included forms of health questionnaires to better understand the participant’s knowledge and to see if they comprehend health issues (Patsopoulou, et al., 2015). Two different assessment tools, Feeding Exercise Trial in Adolescents (FETA) and Childhood Obesity Risk Evaluation (CORE) can identify the patterns in young Greek adolescence. Using gender, age, weight, height, and calculating body mass index (BMI) was crucial to the start of how researchers divided children as being healthy and unhealthy.

Participants that had low to below average scores with understanding CVD has a higher chance of being diagnosed. Education programs need to bear in mind feminine and masculine characteristics in adolescence’s knowledge and behavior toward CVD risk factors to increase information to children and ultimately decrease CVD risk throughout adulthood. Cardiovascular disease (CVD) is the initial reason for death and premature disability. The death rates are increasing globally and approximately more than 17.4 million individuals have died. This amount total is about 30% worldwide. There are many reasons that lead to CVD. Pressure and stress on a young individual can have severe outcomes concerning the body and mind when it comes to health and influencing CVD. Stress can induce many risk factors, such as obesity, high blood pressure, high cholesterol levels, inhaling smoke into the lungs, and drinking alcohol.

All of these factors can start in one’s early life, particularly in one’s childhood years. The more prominent physical and mental pressure is, the more likely that pressure will deliver negative consequences for cardiovascular health. Unhealthy behavioral customs can have an unhealthy diet, eating too many calories in a day, going out to restaurants and quick fast food meals. An unhealthy diet can lead to being not physically active. Laying around in a house all day, sitting in front of a television playing video games instead of playing outside getting exercise can be a danger zone to adolescence. Europe studies factored in maternal ranks to be a link with growth in BMI to their offspring. Health literacy regarding CVD is important because it makes a huge impact on our generation as well as on future generations. Public health can be associated with health literacy. Patient health behaviors have also been associated with low literacy levels.

A person’s background of knowledge, how much they make in a year, their ethnic background and age all can affect poor literacy skills. People who are in the group of minorities and are at the lower end of the socioeconomic status makes this effect out of balance. According to the Center for Disease Control and Prevention (CDC), the definition of health literacy is an extent to how well a human being is proficient, how they convey, process and comprehend essential health information and how to make proper health choices for themselves. Doctors and educators provide knowledge to the public about helping to find information, communicating about healthcare, understanding how to process, and deciding future options for anyone who needs it. Children all over the world might learn about health, well being, and the outcomes of not being healthy in health classes. However, they may not fully comprehend and grasp what they are being told.

The purpose of this paper is to investigate relevant and critical issues related to the health literacy of young adults in Greece and the United States. This analysis will allow understanding of current issues like Cardiovascular Disease that will impact health literacy both in Greece and in the United States. Cardiovascular disease (CVD) can jeopardize the health of both genders. Notara (2018), and her research team completed a study in the following cities in Greece: Athens, Heraklion, Sparta, Kalamata, and Pyros. The study focused on children between the ages of ten and twelve and was in the fifth and sixth grade of the school year. All participants who were studied using an anonymous survey were found to have a better understanding of the knowledge of CVD. To further explain the results of the study, Notara (2018) also included a parent survey.

Questions in the survey dealt with the children’s dietary habits, physical activity knowledge, perceptions of risk factors for chronic diseases, inquiries concerning self-recognition, and how subjects managed their stress. The main categories of the poll were demographic attributes, body composition attributes, as well as knowing the risk factors of the CVD. The parental poll consisted of family demographic attributes and family income. Approximately 50% of fathers and approximately 25% of mothers were overweight and approximately 30% of that were obese. After the study was conducted and the scores were tallied, researchers found that young ladies had higher scores than the young men regarding the answers to having an everyday meal in the morning, understanding that sodas are harmful, and knowing that having hypertension is bad for one’s well-being. Overall, the results revealed the bulk of children have good levels of knowledge about CVD risk factors concerning dietary and lifestyle customs and their outcomes in heart health.

However, more than 50% of young men and young girls said that at their age kids can not have hypercholesterolemia or hypertriglyceridemia. This absence of knowledge about two chronic diseases that most Greek children may have is noted. It was revealed that young girls had a higher mean score than young boys, indicating a more elevated amount of information and attitudes toward several factors that affect CVD events. Between the United States of America and Greece, The country that has accounted for the most astounding group overweight and obesity is Greece. Manios, et al., (2016) used structured questionnaires for there subjects to see if they understand the health literacy of cardiovascular disease using the CORE-index (an evaluation device to predict overweight individuals). This weight prediction device predicted a 30% growth of obesity from middle childhood years to teenage years. Researchers determined that a 3.5 score is the start of recognizing genders for major risks of health issues.

Patsopoulou, et al., (2015) found that overweight and obese kids have to be traced back to their parents. This study targeted the mothers being uneducated in school and how obesity affects mothers as well. Masculine and feminine characteristics learn from their parents and guardians, which has a tendency to pursue in their maternal tracks. Interesting enough, the country that had the opposite outcome was a study did in America. This study also suggested that parenting style also impact childhood BMI. Children who have strict parents have a higher BMI than those whose parents have encouraging and motivational style.

The essential part concerning the attitudes and knowledge related to CVD risk factors is the different genders of kids between the ages of ten and twelve. Feminine characteristics showed greater rankings of CVD risk factors’ knowledge than masculine characteristics. Teaching relevant materials to support healthy dietary and lifestyle patterns should be repetitive lessons for growing children. Education programs need to bear in mind feminine and masculine characteristics in adolescence knowledge and behavior toward CVD risk factors to increase information to children and ultimately decrease CVD risk throughout adulthood.

Multiple studies focus on the attention of overweight and obesity in young adults as a public health dilemma in Greece. Parents education level and socioecological status play a major role as to the health of their offspring. Factors to prevent CVD and obesity can be fixed by not eating without feeling hungry, not eating anywhere but the dining room, motivational family members that have support focusing on children and themselves to a healthier lifestyle. Children in school are learning about themselves and about their growing body. In school learning about healthy eating, healthy lifestyle and how exercise can make an impact on their future selves. Most young ladies will have a mindset of looking slimmer. Most young men will have a mindset of looking bulkier with getting muscles. Getting bulkier can with bad health style customs.

Mental stress can get into one’s head. Better ways to decrease mental and behavioral stress is exercising, sleeping or by just getting preoccupied with something less stressful at that moment. Future studies can look at how well individuals look at healthy literacy is compared with psychological stress is associated with CVD. Educating youth both in the U.S. and in Greece about CVD will promote improved health and less obesity. Understanding how health literacy is connected to the prevention of unhealthy habits is vital to maintaining a healthy long life.

The Novel ‘’The Reader’’

Presents illiteracy as a form of dependence. Hanna’s inability to read and write has a huge impact on her life, especially her shame for it. Throughout the novel it becomes clear that Hanna’s illiteracy affects her on her choices in life and her social skills, which in the end results in Hanna killing herself. She really does a lot to keep her literacy a secret. Hanna’s feels ashamed about being illiterate. She does not want people to know about her inability, so she keeps it a secret throughout her whole life, even from Michael. She enjoys being read to by Michael, but still manages to keep her illiteracy undercover; ‘’ ‘So read it to me!’ ‘Read it yourself. I’ll bring it for you.’ ‘You have a nice voice, kid, I’d rather listen to you than read it myself.’. There are several situations throughout part one in which Hanna’s shame on her illiteracy affects her relationship with Michael. Hanna’s shame sometimes even results in quarrels between the two. In part one of the novel Hanna and Michael go on a trip together.

On this journey, they have a conflict, absorbed from Michael’s point of view. He gets up early and writes Hanna a note that he goes out to get breakfast. Of course, Hanna is unable to read this note. In this state of the book, we as readers don’t know about Hanna being illiterate yet, which leaves us confused, just like Michael; ‘’ ‘What was the matter? Why did you get so angry?’ We were lying side by side, so satiated and content that I thought everything would be cleared up now. ‘What was the matter, what was the matter – you always ask such silly questions. You can’t just leave like that.’ ‘But I left you a note…’ ‘Note?’ I sat up. The note was no longer on the night table where I had left it.’’. Hanna must have hidden the note, so Michael would not find out she was not able to read it. Michael discovers her analphabetism by himself in the trial phase.

In the trial, Hanna’s illiteracy results in her being punished for things she did not do. She gets accused for being the leader of the guards and writing a report. At first, Hanna speaks her truth and tells the prosecutor the report was written by her and the other guards. When a defendant points at Hanna for writing the report, the prosecutor suggests an expert should be called to compare the handwriting. At this point Hanna panics; ‘’ ‘My handwriting? You want my handwriting?…’ ‘’(Schlink, 2008, p. 128) She ends up saying that she admits she wrote the report. Apparently, she was so embarrassed that she would rather take on the entire debt, than people would find out about her illiteracy. This resulted in her getting sentenced to life, while the others received terms in jail.

Hanna’s inability to read and write also limits her in comprehending situations around her. When the judges ask Hanna if she knew she was sending the prisoners to their death, Hanna responses a very odd way: ‘’ ‘Did you know that you were sending the prisoners to their death?’ ‘Yes, but the new ones came, and the old ones had to make room for the new ones.’ ‘So because you wanted to make room, you said you and you and you have to be send back to be killed? Hanna didn’t understand what the judge was getting at. ‘I…I mean…so what would you have done?’ Hanna meant it as a serious question. ‘’ In this passage it is very clear that Hanna has a backlog in comprehending situations around her. She clearly is not aware on how she comes across to the jury.

She gives the trial’s spectators the impression that she cares more about the logistics of clearing out space for new prisoners than about the lives of the people she sent to Auschwitz. Hanna’s backlog in comprehending situations around her, caused by her illiteracy, degreases as she learns how to read and write. This resulted in a very unfortunate Hanna, who finally decides that it is best to end her life. In the state of the novel Hanna is prison. Michael sends her tapes on which he is reading books out loud. In this way Hanna is able teach herself how to read and write. ‘’I read the note and was filled with joy and jubilation. ‘She can write, she can write!’ In these years I had read everything I could lay my hands on to do with illiteracy. I knew about the helplessness in everyday activities, finding one’s way or finding an address or choosing a meal in a restaurant, about how illiterates anxiously stick to prescribed patterns and familiar routines, about how much energy it takes to conceal one’s inability to read and write, energy lost to actual living.

Illiteracy is dependence. By finding the courage to learn to read and write, Hanna had advanced from dependence to independence, a step towards liberation.’’. By learning Hanna is able to understand the impact she had on the lives of the victims who survived. This must have been hard for her. So hard that she commits suicide. Being illiterate in a country that has 99% illiteracy makes it hard for Hanna to function socially. Her shame puts her in difficult situations which affects her life in different ways. Also, the illiteracy enormously limits her in the field of work which results in Hanna being a guard and responsible for a lot of terrible things. All these things summed up together leaf Hanna very vulnerable and unhappy which results her suicide. Hanna being illiterate really forms the story of this novel.

Struggling Adolescent Readers And Strategies For Success 

The literacy skills of the typical American teenager have not improved since the 1970’s but the demand for literacy skills have increased dramatically. Struggling in reading during the adolescent age not only affects reading but other classes throughout education. Literacy challenges of adolescents’ demand strategies to increase success across the curriculum. Why do adolescents struggle with reading? Before educators can successfully intervene, one must know what causes adolescents to struggle in reading. Adolescent readers struggle because of diverse backgrounds/poverty, ineffective past teachers, text complexity, special learning needs and having not motivation. Diverse backgrounds are typical around the United States. Diverse backgrounds are defined as students with an ELL (English Language Learner) ruling and students from less fortunate homes. Igoa (1995) stated, “Many families wait to emigrate until their youngest children are in school and their oldest children are out of elementary school”.

The older children are then struggling to comprehend and read at grade level because of learning English so late in life. Poverty is another factor in struggling with reading. Nichols and Good (2004)These and other social factors that go with living in poverty influence students’ academic progress Another reason adolescent struggle to read accurately is that they have not had reading and writing strategies demonstrated effectively. Cambourne (2001) claimed “Some teachers are simply better than others at teaching reading.” Guthrie and Davis (2003) suggest that some struggling adolescent readers can read grade-level material in elementary school, but this is not surprising. Snow and Biancarosa (2003) point out, “As content demands increase, literacy demands also increase: students are expected to read and write across a wide variety of disciplines, genres, and materials with increasing skill, flexibility, and insight”.

Although the students have been given extra reading instruction, remedial reading classes have typically not been successful. Some researchers, like Allington (2003), theorize that students who have spent years in remedial classes have spent a great deal of time learning reading skills, yet have not spent enough time reading connected texts, possibly because students in special education classes have not spent much time reading. According to Pitcher and her colleagues (2007), “Motivation to read is a complex construct that influences readers’ choices of reading material, their willingness to engage in reading, and thus their ultimate competence in reading, especially related to academic reading tasks”. Motivation is often linked to students’ self-efficacy, or their belief in their own ability. Adolescents Struggle in Multiple Reading Areas

Students who struggle with reading do not merely struggle with reading texts. Adolescents struggle in multiple areas that are all encompassed in the reading curriculum. Struggling adolescents need intervention in word recognition, fluency, vocabulary, and comprehension. Boardman mentioned the ability to effectively and efficiently decode words with word recognition is necessary for reading comprehension. Struggling adolescent readers may be able to read single-syllable words but must be taught strategies to decode multisyllable words common in complex texts. To do this, students must be taught explicit strategies. Archer, Gleason and Vachon (2003) found that teachers who use explicit instruction explain the strategy, model the process, provide guided practice with scaffolding and finally, require independent application of decoding words.

Ehri (2014) found there are three strategies when reading unfamiliar words: decoding, analogizing and predicting. Moats (2006) also found that word study interventions that address concepts that relate to semantic connections are positive effects on reading achievements. Fluency is defined by Hasbrouck and Glaser (2012) as reading with reasonable accuracy at an appropriate rate with suitable prosody that leads to accurate and deep comprehension and motivation to read. It has been confirmed that the human brain can perform tasks such as reading once enough learning has occurred. Therefore, it is important for students to become fluent according to Tindall (2006). Tindall also found that students who read fluently with appropriate prosody tend to have adequate comprehension skills.

Vocabulary refers to knowledge of word meanings. Biancarosa and Snow (2004) find that students’ knowledge of vocabulary is highly related to their ability to comprehend text. Baumann (2003) concluded explicit vocabulary instruction integrated into content with ample opportunities to read, say and write words enhances abilities to learn new words. The absolute goal of reading is to comprehend or understand the text. Direct and explicit teaching of comprehension strategies is recommended for all students and is essential for those who struggle according to Kamil and Pessley (2002). According to Fisher and Ivey (2006), more than eight million students in grades four through twelve are identified struggling readers. It is essential that teachers build relationships with students and asses their individual needs to differentiate instruction. Struggling readers need the use of successful strategies. Some of these strategies include: word study, using fluency, vocabulary and comprehension, and increasing motivation.

Word Study

Moats (2006) introduces the idea of using a word study. Moats states, “Word study interventions that address concepts that relate semantic connections to morphology have significant positive effects on student reading achievement”. Word study involves decoding multisyllabic words and understanding the importance of words. Once students know and understand different types of words, their understanding grows. With the growth of understanding words comes growth with reading.


Hasbrouck (1999) states, “Fluency is reading. The most effective ways to improve fluency include whole reading and repeated reading”. Fluency is a factor that can assist struggling readers gain confidence. According to Smith (2008), fluency can improve with a great deal of well-monitored wide reading. Fluency also involves encouraging students to try and read different types of texts. Other strategies used for fluency include round-robin reading, SSR (sustained silent reading) and drop-everything-and-read (DEAR). SSR and DEAR give the students random opportunities to plainly read a book. Repeated reading and having more opportunities to just read assist struggling readers in the regular classroom.


Strategies in vocabulary learning assist struggling readers. Boardman (2008) explains that vocabulary is more than teaching new words. Students must be able to identify, describe and use the words correctly. Baunmann (2002) found that vocabulary strategies are beneficial to all readers. These strategies suggest teaching multipart strategies. Baunmann explains that multipart vocabulary includes contextual analysis to infer a word’s meaning, morphemic analysis to derive a word’s meaning and the dictionary to confirm. Using the multipart vocabulary strategy with other strategies like interactive word walls and teaching multiple meanings of words will assist all learners.


Teaching comprehension strategies is more than just asking questions about the text, it is fully understanding the text. According to Duke and Pearson (2002), comprehension strategy instruction helps students become purposeful, active readers who are in control of their own comprehension. Graphic organizers and semantic organizers are helpful for all learners, not just struggling readers. Graphic organizers help students focus on text structure, provide students with tools to examine texts and help students write well-organized summaries.

Comprehension also involves teaching struggling students how to ask and answer questions while reading. Pressley (2002) explains asking questions and answering questions while reading not only gives students a purpose for reading, but assists the struggling reader to focus their attention on the text. Giving students questions to answer while reading focuses their minds on the text and encourages students to monitor their own comprehension.


Carbo (2009) found that struggling readers often need more than concrete strategies. Struggling readers need motivation. Many educators often forget that motivation is a factor in comprehension and understanding. Carbo stated, “Students must be deeply interested in what they are reading to do their best”. In order to increase motivation, teachers can use different techniques. Worthy, Moorman and Turner (1999) found that older at-risk readers require the chance to choose what they read. Interest in what is being read leads to a better and more complete understanding. Giving students choices about the content they read, and giving them those opportunities boosts confidence and motivation to read.


Struggling in Reading during the adolescent age not only affects reading but other classes throughout their education. Literacy challenges of adolescents’ demand strategies to increase success across the curriculum. All students have the potential to be successful readers. With the correct strategies and the determination of both student and teacher, even the struggling readers can succeed.

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